Physicians Cautioned About Online Behaviors

Physicians who unwisely use social media to post false information about their credentials or treatments, engage in unprofessional interactions with patients, or post information about patients may find themselves under investigation by state medical boards, a new survey has found. Image: Lisa Eastman /iStockphoto.com.

Physicians are likely to find themselves in hot water for ill-considered online behaviors, such as posting information that misrepresents their credentials or their treatments, violating patient privacy by posting patient photographs online, or sending inappropriate messages to patients, according to a survey of state medical boards. But the survey, published today in the Annals of Internal Medicine, also found there is less consensus among medical boards about whether other types of unprofessional online behavior would result in their investigating a physician.

As physicians increasingly embrace social media use in their professional and personal lives, researchers are studying the potential pitfalls of using these new tools. Nearly all state medical boards have received reports of physicians violating standards of professionalism online, according to a previous survey published in JAMA in March. The most commonly reported violations have been inappropriate communication with patients, such as making sexual advances; inappropriate medical practice, such as prescribing without an established clinical relationship; and misrepresentation of the clinician’s professional credentials.

The latest survey probes which types of online misbehavior are likely to trigger an investigation of a physician by a state medical board. The researchers found a high consensus about some online behaviors that would likely trigger an investigation: posting misleading information about clinical outcomes (81%), using photographs of patients without consent (79%), misrepresenting professional credentials (77%), and making inappropriate contact with patients (77%). The majority of state medical boards agreed that reports of depiction of an intoxicated physician (73%), a violation of patient confidentiality (65%), and use of language that is discriminatory toward a group online (60%) would be investigated. But there was less consensus about other questionable online behaviors, with fewer than half of state medical boards reporting they would investigate derogatory comments about an unnamed patient or patients (46%), depictions of alcohol use without intoxication (40%), and descriptions of patient encounters that do not violate confidentiality (16%).

“Our findings underscore the need for more continuing education of physicians in practice about potential interpretations and consequences of online actions so that their social media presence can be a professional benefit instead of a liability,” the authors conclude.

The Federation of State Medical Boards has posted a guideline for physicians on appropriate use of social media, with suggestions that physicians contact patients only about treatment and never publically, avoid posting any identifiable information about patients, and understand that their postings may be seen by a wide audience.

The American Medical Association (AMA) has also issued a policy on physician use of social media. Among other things, the AMA policy suggests that physicians take steps to monitor and protect their professional image online and remember that patient privacy and confidentiality extend to online forums.